Nightweaning, weaning and nutrition.
by Kathleen Kendall-Tackett, Ph.D., IBCLC There is a movement afoot in childbirth education and perinatal health urging mothers to avoid nighttime breastfeeding to decrease their risk for postpartum depression. We know that if mothers follow this advice, it will have a negative impact on breastfeeding. But let’s put that issue aside for the moment and consider whether avoiding nighttime breastfeeding will preserve women’s mental health by allowing them to get more sleep. In short, is this good advice?
At first glance, it may seem to be. Since breast milk is lower in fat and protein than formula, we might assume, as I once did, that breastfeeding mothers sleep less than their formula-feeding counterparts. When a mother’s mental health is at stake, avoiding nighttime breastfeeding might be worth the risk it poses to breastfeeding. However, recent research has revealed the opposite: that breastfeeding mothers actually get more sleep—particularly when the baby was in proximity to the mother. And that has major implications for their mental health. If you want one more good reason for mothers to exclusively breastfeed their babies, here it is:
Breastfeeding Mothers Get More Sleep In a study of 33 mothers at 4 weeks postpartum, Quillin and Glenn (2004) found that mothers who were breastfeeding slept more than mothers who were bottle-feeding. Data were collected via questionnaire that recorded 5 days of mother and newborn sleep. When comparing whether bedsharing made a difference in total sleep, they found that bedsharing, breastfeeding mothers got the most sleep and breastfeeding mothers who were not bedsharing got the least amount of sleep. Mothers who were bottle-feeding got the same amount of sleep whether their babies were with them or in another room.
Sleep patterns of 72 couples were compared from pregnancy to the first month postpartum via sleep diaries and wrist actigraphy (Gay et al., 2004). Most of the mothers were at least partially breastfeeding (94%) and 80% were exclusively breastfeeding. Most of the babies slept in their parents’ room and 51% regularly slept in their parents’ beds. Sleep and fatigue outcomes were not associated with type of birth, parent-infant bedsharing, or baby’s age. Mothers who were exclusively breastfeeding had a greater number of nighttime wakings (30 vs. 24) compared with mothers who are not breastfeeding exclusively. The exclusively breastfeeding mothers slept approximately 20 minutes longer than mothers not exclusively breastfeeding.
In a study of mothers and fathers at three months postpartum, data were collected via wrist actigraphy and sleep diaries (Doan et al., 2007). The study compared sleep of exclusively breastfed infants vs. those supplemented with formula. In this sample, 67% were fed exclusively with breast milk, 23% were fed a combination of breast milk and formula, and 10% were exclusively formula fed. Mothers who exclusively breastfed slept an average of 40 minutes longer than mothers who supplemented. Further, parents of formula-fed infants had more sleep disturbances. They concluded that parents who are supplementing with formula assuming that they are going to get more sleep should be encouraged to breastfeed so they will get an extra 30-45 minutes of sleep per night.
Not only do breastfeeding mothers get more sleep, the sleep they get is better quality. This study compared 12 exclusively breastfeeding women, 12 age-matched control women, and 7 women who were exclusively bottlefeeding (Blyton et al., 2002). They found that total sleep time and REM sleep time were similar in the three groups of women. The marked difference between the groups was in the amount of slow-wave sleep (SWS). The breastfeeding mothers got an average of 182 minutes of SWS. Women in the control group had an average of 86 minutes. And the exclusively bottle-feeding women had an average of 63 minutes. Among the breastfeeding women, there was a compensatory reduction in light, non-REM sleep. Slow-wave sleep is an important marker of sleep quality, and those with a lower percentage of slow-wave sleep report more daytime fatigue and pain.
The most recent study was published in the journal Sleep, a major sleep-medicine journal not necessarily known for its support of breastfeeding. This was a study of 2,830 women at 7 weeks postpartum (Dorheim et al., 2009). The researchers found that disrupted sleep was a major risk factor for postpartum depression. But here is where it really gets interesting. When considering what disrupted sleep, they found that the following factors were related to disturbed sleep: depression, previous sleep problems, being a first-time mother, a younger or male infant, and not exclusively breastfeeding. In other words, mothers who were not exclusively breastfeeding had more disrupted sleep and a higher risk of depression.
Conclusions The results of these previous studies are remarkably consistent. Breastfeeding mothers are less tired and get more sleep than their formula- or mixed-feeding counterparts. And this lowers their risk for depression. Doan and colleagues noted the following.
Using supplementation as a coping strategy for minimizing sleep loss can actually be detrimental because of its impact on prolactin hormone production and secretion. Maintenance of breastfeeding, as well as deep restorative sleep stages, may be greatly compromised for new mothers who cope with infant feedings by supplementing in an effort to get more sleep time. (p. 201)
In sum, advising women to avoid nighttime breastfeeding to lessen their risk of depression is not medically sound. In fact, if women follow this advice, it may actually increase their risk of depression.
References Blyton, D. M., Sullivan, C. E., & Edwards, N. (2002). Lactation is associated with an increase in slow-wave sleep in women. Journal of Sleep Research, 11(4), 297- 303.
Doan, T., Gardiner, A., Gay, C. L., & Lee, K. A. (2007). Breastfeeding increases sleep duration of new parents. Journal of Perinatal & Neonatal Nursing, 21(3), 200-206.
Dorheim, S. K., Bondevik, G. T., Eberhard-Gran, M., & Bjorvatn, B. (2009). Sleep and depression in postpartum women: A population-based study. Sleep, 32(7), 847-855.
Gay, C. L., Lee, K. A., & Lee, S.-Y. (2004). Sleep patterns and fatigue in new mothers and fathers. Biological Nursing Research, 5(4), 311-318.
Quillin, S. I. M., & Glenn, L. L. (2004). Interaction between feeding method and co-sleeping on maternal-newborn sleep. Journal of Obstetric, Gynecologic and Neonatal Nursing, 33(5), 580-588.
Kathleen Kendall-Tackett, Ph.D., IBCLC is a health psychologist, board-certified lactation consultant, and La Leche League Leader. She is clinical associate professor of pediatrics at Texas Tech University School of Medicine in Amarillo, Texas.
For more information, visit her Web sites: UppityScienceChick.com and BreastfeedingMadeSimple.com.
When will this END?????
My firstborn girl, - 4 years and 2 months - just fell asleep tonight for the first time in the room she shares with my second born girl - 9 months, that we just finished organising. I know bb L,9m will end up in our bed in the middle of the evening or the night ... but our firstborn was just so happy to have her own bed in her own room, falling asleep after a little story read by her dad while I was breastfeeding baby L to sleep very near her. D, my husband says we had to tell you - L - since exactly what you said (or almost) happened - at one of theme meeting you gave !Finding our tandem nursing rythm wasn't easy, took few months and now my firstborn has maybe one feed a day and I think we already have had a day without a feed. Amazing ! it is true that one day they DO grow up, stop breastfeeding, stop waking up in the night, want to sleep in their own room, and so on.I am so proud to have been able to wait until my first born was ready to find her own sleeping pattern/rythm without letting her cry it out, without night weaning even ! I think she is in a natural weaning process since sometimes she has micro feeds, sometimes very long feed. Thanks so much for supporting me and my husband on this family path. Being a couple was beautiful but being a family is really empowering. Bises to everyone.
Mother of 2.
When you are sick of being a nighttime "soother". Testimonies.
Thank you all for sharing your stories and experiences :=) I feel that my confidence as a mum and as a woman is growing as G is getting older and that I trust him to lead the way. But there are so many moments of doubt, of loneliness, of solitary joys that reading you , experienced mums out there ,makes me feel warm and part of a great community. When I get into a difficult situation of being confronted / compared to babies sleeping through the night at 3 months old or those who never cry as their mum leaves the room, I think about you, about us and I find strength in me :=)
Charlotte, I was at the grissini stage until last week with the crumbs in my bags and all- now its grapes!! Great for the park where G looooves to ask for nana....and to divert attention...
I would like to adress the theme of "tetouiller", aka know as" my nipple is his dummy!" G - 14 months-sleeps in his cot in our room until 5am, he then usually stands up and says 'mamannnnn', my partner picks him up and he nurses back to sleep with us until 7 or 8am.
But recently, he is not accepting to let go of my nipple, he drinks and then keeps it in his mouth, dozes off but when I gently unlatch him, he fusses and wakes up. I can t fall back asleep even though I’m a really good sleeper and my nipples are now sore!!! I am not enjoying this at all. This is the only time when he does this. His other feed is the evening feed. We were thinking of trying to soothe him at 5am in his cot and set his morning feed a bit later, when we get up...What do you think? Any suggestions?
You are an inspiration to me, you know, you are always so grounded and calm whenever I see you, and G is such a jolly and curious lad.
I went through this too, the whole tantrum 'I can't sleep unless your nipple is perfectly in my mouth rrr!!'.
I diligently indulged my baby G until he was about a year and then I began explaining to him that it really bothered me, it irritated my 'boobies' (as we call them in our house) and that it just wasn't working for me. That I was happy to help him fall back to sleep another way but booby-sucking for hours just wasn't going to do it.
I did this because it was clear that :
a) he was yelling more from anger than from distress,
b) that he was not hungry anymore and
c) he was old enough, in my opinion, to be able to communicate, take my needs into account a bit and grow into a new version of soothing.
So, after his feed, I would pull my nipple out and he would either yell a bit but fall back to sleep with some back-rubbing or stroking, or we would get up and do something else until he was really tired. I know the prospect of getting
out of bed a 5 am sounds hard, but for me it really was no longer an option to lie in bed not sleeping with my nipple being chewed on...
Your solutions sound great! Try them and let us know what works!
Hi. Julien did that too. Drove me crazy. At first I took him off and tried to soothe him to sleep but he would keep waking me up, every 45 minutes later. He's hungry, thats the problem. I suggest you get partner to get up with him, feed him something heavy, then have him bring him back to bed to you where he nurses then goes back to sleep.
I Know its hunger because Julien STILL wakes up but I left him to sleep with his father a year ago (he turned two then) and he still wakes up frequently between 5 and 7;30h (the "legal" waking up mummy time) and feeds him crackers. (IN the bed!!! His bed, not mine) I think its inacceptable but Julien eats crackers, drinks from the bottle (mineral water bottle I mean) goes back to sleep, often pees in the bed (that his father, doesn't bother to change the sheets after and I’m damned if I’m going to do it) then gets up to come to my bed as of 7;30h. I'm so grateful he keeps him with him, I dont say much about the cracker crumbs in the bed with the same sheets despite a few pees in bed.
I used to refuse to nurse as of midnight, from age… I think for Julien it was 2 yrs, but for Alex it was 19m.
But I started to refuse feeds between midnight and 7am. I explained over and over and over again that the shop was closed until 7am, day time. So Alex used to wake up and say "is it daytime yet?"
But Julien climbs up the mezzanine ladder where I sleep and says "mummy, c'est le jour, c'est le jour" regardless of what time it is.
He kisses he big brother who lies sleeping peacefully too before he rips down my nightshirt to get to nanas.
So in theory I would say the shop opens as of 7;30h but in practice, the shop opens when Julien escapes his father and informs me it is day time.
If you read "the no cry sleep solution" by Elizabeth Pantley you'll get some really good ideas and lots of options too.
You're so close to being in the clear now. If you dont go and get pregnant again, you will get another year or two of uninterrpted nights before it all starts over again with prengancy and newborn and two sibling family....
(do you hear the fatigue in my tone?)
Lots of lovee to you, and congratulations for opting for the route that takes more time, more effort, more patience, more energy, more love, and more contact for a so much richer child and parenthood.
Hi, I know you've already gotten many replies, but I wanted to share our story (esp. re the breastfeeding) in case it is helpful to you:
I carried A most of the time until she was about 2-2 1/2. Even when we also took the stroller with us for longer excursions (mostly with my husband), I carried her much of the time when she was awake (she slept well in the stroller). From when she was about 2 we used the Manduca on my back, which helped me a lot with back pain problems I was getting. (Not so much due to her weight, but because I'd never dealt with them after 7 weeks of pregnancy hospital bed rest on a terrible mattress!)
After she was 2 1/2 I didn't carry her as regularly, but I still did from time to time and for short stretches because we both loved it. I had to stop completely only when I got pregnant with my second when A was four.
I remember getting funny looks when I carried her in the front when she was older, but not so much in the back.
Re. breastfeeding: A nursed until she was just under 3 1/2. I nursed her when she wanted it until she was 2 1/2 and then less in the night because she moved into her own bed (next to ours) and I felt I needed more sleep. Luckily the transition was easy for her.
Around that time and especially when she had started school, I received almost constant negative comments about still breastfeeding her from my MIL, and finally her Papa also started to say that he thought we should stop (he had been a wonderful supporter of our breastfeeding up until then and I don't think I would have managed the first difficult weeks without his constant encouragement, but at this point he felt - I'm sure somewhere deep inside influenced by his mother - she shouldn't be nursing anymore when she started school at almost 3).
I wish now that I had been stronger and firmer about not accepting any comments - even semi-humorous or friendly comments - in front of A, because although I tried to ignore them (water off a duck's back approach), they DID affect me and make me feel uncomfortable, and I truly believe that they affected A. During this time she weaned herself, wanting to nurse less and less frequently until she finally stopped. It's true that that made weaning a smooth transition for us and that she enjoyed the positive feedback she received from her Papa about being a big girl etc. And I actually don't think we would have nursed much longer in any case - A has a very independent little spirit. But I for quite a long time felt sad that I had allowed those negative comments to affect her weaning-time.
Good luck - from your message I gather how much you enjoy both carrying and nursing. This closeness with our children lasts for such a short time anyway, so I truly believe it is best to let your feeling and intuitions and your child guide you in those decision rather than anyone from the outside.
Hi. You've got some really really beautiful answers here. I just wanted to say that I nursed "on cue" my firstborn until he was 3 and I regret it. I nursed him until he was 4 but I really wished I'd set some limits like "not at the park", and "not in the metro" and "not in the RER at rush hour" etc. He would nurse, (even at age 4) then fall asleep in my arms while nursing and I had to deal with carrying the great lump of a 4 year old in my arms with bags, and stuff up metro stairs, everywhere. I had a wrap of course but at that age, I carried him on my back and you just cant put a sleeping 3 or 4 yr old on your back in a wrap on the RER platform or in a metro with lots of bags of stuff without provoking enraged screaming demanding to breastfeed back to sleep again. I tried it a couple of times, and he made such a scene, with all the passengers gawking and wondering what torture I was submitting him to. Wont do that again.
Couldn't leave the bed, let alone the room when I nursed him for a seista and had to run back to him in the evenings about 4 times between 9pm and midight because he would wake up screaming if the breast was no longer in his mouth.
Sooooo. A little wiser for my second born; having read Elizabeth Pantely's "no cry sleep solution" and "mothering your nursing toddler", this time, I took him off the breast as soon as he started "tétouilling" you know, sort of sleep nursing, but not drinking. I started that as of about a year I think, maybe younger. Cant remember now.
Also, the limits on no breastfeeding in the park or metro was a lot easier this time because I started carrying Julien on my back as of age 1. I kept Alex in front until he was 2.
When you carry on the back they start getting sleepy just as they do in front, but this time, they cant get access to the breast. That can be a crisis for some, but for Julien I just passed him crackers, and he would eat them, protesting, but falling fast asleep with cracker crumbs spilling out of his mouth.
I would put the cross side of the wrap over his head so it wouldn't loll backwards, and he would spend a lot of siestas that way. That really imposed limits on where we can breastfeed without much effort.
Not in the park was a little more difficult because he was free to run around and rip off my t-shirt any chance he got, but I used my ever faithful crackers again. I started with grissinis because they were easy for him to hold. So we lived with grissini crumbs and bits of broken grissinis in the wrap, on the floor where I undid the wrap, in his clothes, in my bags, everywhere, until we got a promotion to crackers. Good old saltine crackers. 'Cept they dont have the salt on them anymore. But Julien loves them, and I depend on them as a real mothering/calming/apetite calming/negotiating tool. Of course older, he needed to nurse non stop if we weren't anywhere near a table, to get to real food, so I let him get a good long slug of the breastmilk, then offered crackers. Brilliant things.
I carried Julien in the wrap on my back until I got a Manduca and carried him always on my back with that until he was about, I dunno, 2 and a half I guess. Not all the time, just if it was far, by metro or I had to go quickly, or I knew there was a risk he would fall asleep in the metro or RER.
The Manduca is much more adapted to growing bbs than the Ergo I find. However, Julien went from a plastic 4 wheel car that he pushed along (putting big holes in the fronts of his shoes), to a tricycle very very early. He used a tricycle as of 18 or 19 months. I pushed it with a bar to keep on the straight and narrow because even though he mastered the pedalling perfectly, he, like all children I think wanted to "explore" the sidewalk by zigzagging all over it, looking at garbage in the gutter, trying to open car doors, hitting the side view mirrors, and trying to run into hurried pedestrians for a laugh.
Then we got a "vélo sans pédales". A no pedal bicycle.
He got that when he was 19m old but we didn't let him use it outside until he was almost 2. About 22 months I think, yes, 22 months. Oh man, you really have to know you can trust your child with that thing.
He of course used it to the max in all the parks and I let him use it on the sidewalk as long as he agreed to go slowly enough to allow his panting out of shape mother keep up with him. I got mad at him if he went too far away, explaining over and over again the risk of cars that dont stop and scooters on the sidewalk.
He understands the risk of cars, that is for sure, so he stops at every edge of sidewalk and waits for me. I'm quite well known in the neighbourhood as the running mom.
Whevever we go, he shouts, singing, whatever, at the top of his lungs, (I think he's happy) and I run as fast as I can to keep up with him. Sometimes I get stuck behind slow pedestrians, so I get a bit panicky but he always waits at the edge of the sidewalk before a road. I know the risk is there,. I know he may just let a game get the better of him and dash out, it is possible, but so far, he has always, always stopped. I usually start screaming "JUILIEN STOP! JULIEN STOP!" from behind him if I see him going full speed toward the edge of a road, but so far.... knock on wood... He seems to understand, always repeating to me how dangerous cars are and how daddy kicked a car who cut them off as they crossed the crosswalk together because the car was very very méchant. Often, as I walk to catch my breath, I find him at the bottom of an escalator or something, with his miniature vélo, as some old lady or concerned man bends over to talk to him, asking where his mother is and what is his name. (thinking he is lost).
Julien loves talking to anybody so its all a great big adventure for him. He tells the person his name, his age, that he can count to 20 and usually demonstrates.
I trot up panting and thanking the person for their concern.
Did I tell you how he used to target the people in the pedestrian presinct (spelling?) where the supermarket is?
They would all be carrying heavy shopping bags from the super market, and Julien had realised a long time ago that bags being suspended at the end of people's arms were movable, not solid, so he would "roule" as they say in french, as fast as he could towards them, aiming at the heavy bags, so he could do a "stunt" or cascade as Alex calls it. Smashing into the suspended bags, and keep on going.
Most people were very agile and began to hop from foot to foot as he neared them at top speed, and turn sideways at the last minute, so he just sped by, and I got a LOT of dirty looks. I apologised profusely saying he wasn't very good at it yet, he was just learning, but I was lying. He was doing it on purpose. He would shout/sing of course as he approached, so no one can hear anything else but him, he's so loud, and total confustion reigns because the poor people are trying to avoid having Julien smash into them.
Anway. So all that is to say that if you go to "wheels" (Alex was a master of trotinette by the age of 2 and a half) you will find that at least locally, you have a very happy child, and arms and back a lot more free.
I think the thing to remember is that naturally, the carrying, whether its on the back or the front reduces itself just by the maturing of the child. I think we can all say that we carrry until at least the age of 3, but its not the intense all day thing it was when they were bbs.
Its not like a stroller, where once you use one, its pretty well full time, every time, no exception, from birth to age 6.
Personally I will choose any form of wheels other than a stroller, every time, as age permits. I think strollers are the biggest scam in our parenting concept of things. There are so many other choices of practical, fun, dexterity, agility, coordonation building wheels to use, other than a stroller.
Thank you for that testimony Charlotte
It is really interesting and I will certainly buy some grissinis!!!
I think you got some great replies so just a quick one to let you know that when this happens with M, I change boobs and he goes to sleep really quickly. It's just a quick fix but sometimes, in the middle of the night, it does the trick. As Charlotte said, they seem to be hungry.
Also, I have some friends who don't co-sleep and baby sleeps in her own room and they were really happy because at about 12 months she started sleeping throuhg the night and then, a few months later, she started waking up again. I'm not sure it is just a co-sleeping issue. Maybe babies go through stages as you say. A good friend once told me: never take anything for granted with a baby. I am starting to understand what she meant. Things come and go, it's not a straight line forward but a wiggly one ! ( -;
You sound as if you are doing a great job. I often take inspriation from your answers.
Look forward to meeting you at la rentrée.
Thank you for your message E.E.) I think Charlotte is right, light attracts light and we recongnise each other in many ways. Thanks for your nice words, but I feel so messy and unsettled at baby groups around other cool mums, especially you elizabteth, so sweet and with always a kind word for everyone... :=) funny what we think of ourselves and what we send out huh?!
Anyway, your message really helps me to understand that G is now close to 15 months, not a little baby anymore, that I can talk to him and strat to reconsidere my needs again!! Yey!!! The nipple sucking has gotten worse (practically all night), partner sleeping the other side of the bed is getting grumpy about it...but is happy to help me soothe G during the night!so I will try to gently explain things to G and talk to him about me and how I feel.
Thank you for your lightxx
I also went through a period of this with M.G. and it made me very grumpy. Like E.E. I gently explained to her that the nipple had to come out of the mouth when she was no longer feeding. She would get quite cross indeed sometimes which wasn't always easy to handle but I could not stand it, I simply hated feeling that my breast had been turned into a washed out old dishrag! I offered her alternative comfort and it was one of the reasons my husband became much more active in putting her to bed because even when she went to sleep on the booby for me she simply woke up as soon as I tried to remove it despite the fact that she was no longer sucking it and was then much harder to settle than earlier. So gradually we seperated having the booby before going to bed from going to sleep with the booby.
I think one of the reasons this may be difficult for them is that it's actually quite hard to take a nipple out of a baby's mouth in a totally gentle, gradual way. I had an interesting conversation with my midwife last week during our haptonomie session where we talked about presence and that how you leave a baby or child when they're sleeping can be very decisive as to whether they stay settled or wake up. If the way we leave them is too abrupt then they feel abandoned. But it is so hard when removing a nipple to be really gradual! I tried many techniques and especially as Maya often clamped me, didn't find it easy to do in a gentle enough way. I think if i faced this situation again I would try to remember to talk to her gently and simply about what I was going to do before removing the breast and replace the presence of my breast with perhaps my hand on her cheek or something very gentle instead, maybe caressing her or something. And then again when it was time for me to leave doing the same. All sounds a bit long winded for the middle of the night though! Anyway, all that to say that the question of presence and how to withdraw that presence gradually and gently is a really interesting one and I think quite complicated sometimes with the breast in their mouth!
Lots of love to you and G I think your own suggestions seem great and that you'll soon find a new way.
I could share my experience because it seems to work... (for now!)
My daugther will be 6 months on the ninth.
Since she has turned 3, I used to take off my nipple once she had fallen asleep.
Of course ,she woke up sometimes but Less and less.
When she wakes up again, I bf her again so as to make her really full and then she falls asleep in my arms with the nipple in the mouth. Once she begins to open he mouth because she is asleep, I take it off. If she wakes up, she is very tired and then I give her to her dad. And he rocks her gently (Bercer?) until she falls asleep.
That way, she gets the habit to fall asleep without nipple too.
Now we can put her in the bed and she sleeps without crying.
Of course it does not work every time!! (no wonder huh!!!).
But when she does not want to go to sleep on her own, we do not let her cry and take her immediatly. That way I feel she can understand that of she needs us, we are there. So usually, after a day when she sleeps in our arms , she agrees to sleep on her own.
Oh yes, I have to add that we play a lot in her bedroom and in her bed so with her so that she can feel comfortable, secure and happy in it.
She has two toys in it and sometimes, she wakes up after we let her and we hear her play 10minutes.
Maybe all this worked on my baby G.V. because she has that type of character but I share it anyway if it can bring some ideas...?
And finally I want to tell that her father carries her A LOT and skin to skin. So maybe she is used to fall asleep against a breast without nipples. It may have helped.
I hope you are doing well.
Not Nightweaning? Weighing the costs with experience
Thank you for your message, I really share your opinion about night weaning, so I don't always participate in all the conversations on the subject here ...
I never really tried to night wean my son, but when he was waking up very often at night and I was fighting against it and feeling guilty to nurse him back to sleep etc ... it was really exhausting (I was working in the day, with 45min drive to my office place). Everything changed when ..... I accepted the situation ! (after reading on the subject and going to a wonderful meeting with Lea Cohen on cosleeping) The material situation remained the same, but I was feeling it was ok for my son to wake up and to nurse back to sleep,and I felt very very less tired !!! I agree with you, lacher-prise is the key ! (And buying a "barrière de lit" to feel safe at night) I even realised that I cherished these night nursing sessions, being separated all day because of work ... My son continued to wake up almost every night until he was 2, then he woke up a little less until 2.5, and he weaned himself when I was pregnant with my second born around 2y and 8 months, and he slept better around 3y (the difference was that I did not have any more the magical solution of nursing to get him back to sleep when he happened to wake up ...) Now my first born, almost 14 months old, has only slept 2 complete nights in his entire life ... ;-) I don't really know how many times he wakes up at night (and I don't want to know ! I think it is between 1 and 5 times perhaps ?) but night weaning is not in our immediate future either !I know that it is our solution and that it would not suit everybody, I just wanted to share my point of view and my experience on the subject. Happy christmas eve for everybody, and courage for all of you having sleeping issue !
Hello everyone,Thank you to M.F.A. for proposing NOT to night wean. It certainly is a viable option.Last night, after finding more pillows to make side-sleeping more comfortable, I have to say, I had one of the most restful nights in a while. My daughter (my second born) must have nursed 4 or 5 times during the night, but that didn't stop me from enjoying my sleep and our cuddling. In the past, I always felt pressured to stay on my side in an uncomfortable position, until my baby was fast asleep so I could turn over onto my back. This resulted in unnecessary stress, especially since she often wokes up as soon as I move. But now, I don't have to worry about all that. I just need to convince my husband that there's no real need to get our baby to sleep in her own bed. He wanted us to night wean for that reason, since he doesn't sleep as well with her in our bed. I'm sure he will once we get a bigger bed (ours is just a 140 cm).Usually, our baby falls asleep around 10 p.m. and wakes up at around 2:30, 4, and 6 a.m. It's not an extreme case.Thank you to M.F.A. and M.M. for suggesting "lacher prise" - an excellent technique that I am working on.Love,R.B.
BGH to Blame for Rise in Twin Birth?
• Diet Linked to Twin Births
Scientific American, May 22, 2006
Straight to the Source Diet Linked to Twin Births
Scientific American, May 22, 2006
Over the last 30 years, the number of twin births has nearly trebled. This rise seems to have followed the introduction of in vitro fertilization and a preference for having children later in life. But in the mid-1990s, doctors began limiting the number of embryos transferred in the course of in vitro fertilization and still the proportion of twin births rose. Now new research seems to show that bovine growth hormone in the food supply may be responsible.
Using data obtained from mothers by way of questionnaire, physician Gary Steinman of the Long Island Jewish Medical Center and his colleagues compared the number of twin births from moms who consumed meat and/or milk and those who consumed no animal products at all. They found that the omnivores and vegetarians were five times more likely to have fraternal twins than the vegans.
In a report published in the current issue of the Journal of Reproductive Medicine, Steinman argues that insulin-like growth factor, a protein released by the liver in response to growth hormone, may be the reason. Studies have shown that the protein increases ovulation and that it persists in the body after entering via digested food, particularly milk. Drinking a glass of milk a day over a 12-week period raised levels of the protein in the body by 10 percent. Vegan women, it turns out, have 13 percent lower concentrations of it in their blood.
Steinman observed in the May 6 issue of The Lancet that although the twinning rate in the U.K.--where bovine growth hormone is banned--rose by 16 percent between 1992 and 2001, it increased by 32 percent in the U.S., where the substance is not banned. Of the new work he says: "This study shows for the first time that the chance of having twins is affected both by heredity and environment or, in other words, by both nature and nurture."
Subject: rBGH MILK MAKES TWINS
MILK FROM COWS INJECTED WITH GENETICALLY ENGINEERED HORMONES MAKES TWINS
New research shows that consumers of hormone-tainted dairy products are five times more likely to have fraternal twins than vegans. In a report published in the current issue of the Journal of Reproductive Medicine, researchers linked recombinant bovine growth hormone (rBGH) with this rise in twin birth rates. The study shows how rBGH, a synthetic growth hormone used to increase milk production in dairy cattle, increases ovulation in humans and persists in the body after entering via digested food, particularly milk. Monsanto's controversial hormone has been banned in almost every industrialized country in the world, due to scientific evidence indicating that the milk from injected cows contains more pus, antibiotic residues, and IGF-1, a potent cancer tumor promoter. Consumers can avoid dairy products that contain rBGH by purchasing organic dairy products or by looking for labels on natural products that say rBGH or rBST-free.
Il existe un site qui associe dents et ostéopathie, faire une recherche : dents vivantes.
Allaitement et caries : aucun rapport
Breastfeeding and infant caries : no connection. B Palmer. ABM News and
Views 2000 ; 6(4) : 27.
Mots-clés : caries, santé dentaire, allaitement.
Certains auteurs ont recommandé que l'enfant soit sevré au moment de l'apparition des premières dents de lait, sous prétexte que l'allaitement augmente le risque de caries. Aucune étude n'est venue confirmer le bien-fondé de cette recommandation.
Dans une étude publiée en 1999, Erickson concluait que si les laits industriels étaient cariogènes, ce n'était pas le cas du lait humain. D'autres auteurs ont remis en cause la méthodologie d'études ayant retrouvé un lien entre l'allaitement et la prévalence des caries. Oulis, dans une étude publiée aussi en 1999, constatait qu'un allaitement d'au moins 40 jours
abaissait le risque de caries. Dès 1977, une étude avait constaté que le lait humain permettait in vitro une reminéralisation de l'émail lorsqu'il avait été artificiellement déminéralisé. Les caries sont favorisées par la
colonisation de la cavité buccale par le Streptococcus mutans, et les anticorps du lait humain peuvent inhiber la croissance de ce germe. Des études ont constaté que la prévalence des caries était très basse pendant la préhistoire.
Berkowitz concluait que les caries constituaient une maladie infectieuse rampante, essentiellement liée à la présence dans la bouche d'une souche microbienne particulière, le Streptococcus mutans. Cette bactérie peut être transmise à l'enfant par son entourage. Sa multiplication jusqu'à un seuil où elle devient pathogène serait la conséquence de l'exposition fréquente et prolongée à des substances cariogènes.
Certains ont estimé que le lactose était cariogène, comme le glucose ou le saccharose. Mais le lactose présent dans le lait humain est accompagné de tout un environnement enzymatique et immunologique. Par ailleurs, la lactase agit au niveau de l'estomac. Le lactose est le sucre spécifique du lait, et il est présent dans le lait de quasiment tous les mammifères. Pourquoi les
humains sont-ils les seuls mammifères à présenter un taux significatif de caries ? Pourquoi les caries dentaires ne sont-elles apparues dans l'espèce humaine que depuis 8000 à 10.000 ans ?
L'observation a permis d'identifier divers facteurs qui augmentent le risque de carie :
· Le sucre représente le plus important facteur de risque ; cela inclut le sucre raffiné, mais aussi le sucre caché dans les aliments : jus de fruits, boissons sucrées, fruits secs, céréales sucrées., ainsi que les médicaments contenant du sucre. Il semble que ce n'est pas la quantité de sucre qui constitue le facteur le plus déterminant, mais plutôt la fréquence
· Le moment d'apparition des premières caries induites par les bactéries dans la bouche de l'enfant, et le nombre de caries.
· La xérostomie (sécrétion salivaire très faible ou inexistante).
· Une maladie ou un stress de la mère ou du fotus pendant la grossesse.
· De mauvaises habitudes alimentaires familiales.
· Une mauvaise hygiène buccale et générale dans la famille.
· Une prédisposition génétique familiale (contribution mineure).
Absolument rien ne permet de penser que l'allaitement puisse favoriser les caries. L'allaitement représente la norme pour notre espèce, y compris en ce qui concerne le développement correct des arches dentaires et des structures faciales dans leur ensemble. Il est temps que les professionnels de santé commencent à éduquer le grand public sur l'importance de l'allaitement en matière de santé dentaire.
Propriétés cariogènes des différents types de lait
Cariogenicity and cariostatic properties for different types of milk - Review. PM Duarte, LC Coppi, PL Rosalen. Arch Latinoam Nutr 2000 ; 50(2) : 113-20. Mots-clés : lait, caries dentaires.
L'objectif des auteurs était de mieux évaluer l'impact des différents laits sur la santé buccale, et en particulier leurs propriétés cariogènes ou cariostatiques. Différentes études ont été menées sur le lait humain et le lait industriel, mais on ignore encore beaucoup de choses.
Le lait de vache frais contient des composants cariostatiques, tels que la caséine, les lipides, et des enzymes antibactériennes, bien qu'il contienne 4% de lactose, sucre supposé cariogène. Des auteurs ont relié l'allaitement à la survenue de caries d'un type spécifiques, dites « caries du biberon », mais des études plus poussées n'ont pas mis en évidence un quelconque impact
cariogène du lait humain. Le lait industriel, couramment donné à de jeunes enfants, reste le moins étudié en ce qui concerne son impact sur la prévalence des caries.
Il serait très intéressant d'étudier les propriétés cariogènes et cariostatiques des différents laits consommés par les enfants, et leur impact sur la prévalence des caries pendant l'enfance et à l'âge adulte.
Allaitement et caries
Investigation of the role of human breast milk in caries development. PR Erickson, E Mazhari. Pediatr Dent 1999 ; 21(2) : 86-90. Mots-clés : lait humain, caries « du biberon », pH buccal, facteurs de risque.
Le but de cette étude était d'évaluer la nature des relations entre l'allaitement et les facteurs de risque pour les caries dites « du biberon ».
Pour ce faire, les auteurs ont mesuré le pH buccal de 18 enfants allaités âgés de 12 à 24 mois avant et après une tétée, afin d'en déterminer les variations. Ils ont aussi cultivé une souche de Streptococcus sobrinus 6715 ayant été incubée pendant 3 heures en présence de lait humain, pour appréciation de la croissance bactérienne et mesure du pH du milieu de culture. De l'émail dentaire réduit en poudre a aussi été incubé pendant 24 heures dans du lait humain, afin de déterminer le taux de solubilité de cet émail en présence de lait humain et en l'absence de bactéries. Les auteurs ont mélangé du lait humain à des doses croissantes d'acide afin d'en mesurer le pouvoir tampon. Enfin, ils ont fait des « trous » dans l'émail dentaire
de prémolaires, les ont colonisées avec du Streptocoque mutant, puis les ont incubées avec du lait humain. Les caries survenues dans ces prémolaires ont été étudiées visuellement et radiologiquement au bout de 12 semaines d'incubation.
Les résultats ont montré que le lait humain n'induisait pas plus de variations du pH buccal qu'un rincage à l'eau claire. Il permettait une croissance modérée du Streptococcus sobrinus. Un dépôt de calcium et de phosphates était observé sur la poudre d'émail après incubation avec le lait humain. Ce dernier avait un pouvoir tampon très faible. Enfin, aucune carie
n'était constatée après incubation dans le lait humain seul, même après 12 semaines ; si par contre on ajoutait dans ce lait humain du saccharose à un taux de 10%, des caries apparaissaient au bout de 3,2 semaines.
Les auteurs concluaient que le lait humain n'induisait pas de caries dentaires.
Caries et allaitement
A systemic overview of the relationship between infant feeding caries and breastfeeding. J Sinton, R Valaitis, C Passarelli et al. Ontario Dentist 1998 ; 75(9) : 23-27. Mots-clés : caries « du biberon », allaitement long.
Les auteurs de cet article ont passé en revue la littérature médicale parue sur les relations entre les caries dites « du biberon » et l'allaitement chez les jeunes enfants. Ils ont passé en revue 151 articles, et ont estimé que 28 d'entre eux étaient pertinents au vu de leur conception et de la population étudiée. Les études de cas cliniques n'ont pas été prise en compte. La fiabilité de ces articles a été définie en fonction d'une échelle préétablie comme étant importante, moyenne, faible et très faible. Aucun article n'était très fiable ; 3 étaient moyennement fiables, 9 étaient peu fiables, et 16 étaient très peu fiables.
Les principaux biais de ces étude étaient méthodologiques. Très peu prenaient en compte les variables démographiques. Les définitions données pour l'allaitement étaient plus ou moins inexistantes, obscures, variables d'une étude à l'autre. Des caractéristiques importantes pour l'allaitement n'étaient pas données. Les 3 articles dont la fiabilité était moyenne retrouvaient tous les 3 une association entre l'existence de caries « dubiberon » et la poursuite de l'allaitement après 12 mois, ou avec l'existence de tétées nocturnes alors que l'enfant avait déjà des dents ; un de ces articles trouvait que les enfants allaités avaient à la fois un risque plus élevé et plus faible de présenter ce type de caries. Les études très peu fiables concluaient à l'existence entre l'allaitement et les caries d'aucune corrélation, ou d'une corrélation positive ou négative.
Les auteurs concluaient que rien dans la littérature médicale existant actuellement ne permet de conclure qu'il y a ou non un rapport entre l'allaitement et le risque de carie. Dans la mesure où l'allaitement long présente de multiples avantages, ils recommandent donc aux professionnels de santé de ne pas utiliser le prétexte d'une augmentation du risque de caries
pour conseiller à une mère de sevrer son enfant. Ils présentent ensuite un certain nombre de mesures de promotion de l'allaitement et de prévention des caries chez les enfants.
Allaitement prolongé et caries
chez des enfants de 18 mois
Dental caries and prolonged breastfeeding in 18-month-old Swedish children.AL Hallonsten, LK Wendt, I Mejàre et al.In J Pediatr Dent 1995 ; 5 : 149-55. B Review 1999 ; 7 : 37.
Cette étude suédoise comportait 2 volets. Une étude épidémiologique a évalué la prévalence des caries et de l'allaitement long chez des enfants de 18 mois. Pour ce faire, 3000 enfants, suivis dans 46 centres de consultation ont été étudiés. 200 de ces enfants ont été enrôlés pour le second volet de l'étude, qui a évalué avec précision les habitudes alimentaires, le brossage
des dents, l'utilisation de fluor, et a effectué une mise en culture de prélèvements buccaux à la recherche de Streptococus mutant et de Lactobacillus. Les enfants ont été répartis en 4 groupes :
· groupe 1 : enfants non allaités et présentant des caries
· groupe 2 : enfants allaités et présentant des caries
· groupe 3 : enfants allaités ne présentant pas de caries
· groupe 4 : enfants non allaités et ne présentant pas de caries
Au total, 2,1% de ces enfants de 18 mois présentaient des caries, et 2% étaient toujours allaités. Parmi les enfants qui étaient toujours allaités, 19,7% présentaient des caries, contre 1,7% des enfants qui n'étaient plus allaités.
Après étude des différents paramètres, il apparaissait que, en dépit de l'importante différence notée ci-dessus, l'allaitement en soi n'avait aucune relation avec la prévalence des caries. Qu'ils soient toujours allaités ou non à 18 mois, les enfants qui souffraient de caries étaient ceux qui consommaient le plus d'aliments cariogènes. 67% des enfants étaient
porteurs du Streptococcus mutans, et 13% étaient porteur du Lactobacillus. Les caries étaient plus fréquentes chez ces enfants, qu'ils soient ou non encore allaités.
Les auteurs concluent que certains enfants développent très tôt des habitudes alimentaires néfastes, qui augmentent nettement le risque de caries précoces. L'allaitement long n'est pas en soi un facteur de risque pour ce type de caries, dans la mesure où les autres aliments pris par l'enfant sont peu cariogènes.
Pratiques de maternage caries dentaires
Child-rearing practices and nursing caries. JR Serwint, R Murgo, VF Negrete, AK Duggan and BM Korsch. Pediatrics, Août 93, 92 : 233-37.
Le terme "caries alimentaire" recouvre un type d'altérations dentaires affectant les incisives centrales et latérales du maxillaire, ainsi que les premières molaires. Dans la littérature, ce type de caries est attribué au don de biberon après l'âge de un an, au don nocturne de biberon, et aux difficultés qu'éprouvent les parents à dire "non" à l'enfant. Cependant, de nouvelles études amènent à penser que cette pathologie a une origine multifactorielle. D'autre part, nombre d'enfants continuent à avoir des biberons passé l'âge de 12 mois, ainsi que des biberons la nuit, sans pour autant présenter des caries. Les auteurs de cette étude se sont posé les questions suivantes :
· Les enfants qui présentent ce type de caries continuent-ils à recevoir des biberons après un an ou la nuit plus souvent que les autres enfants ?
· Ces enfants ont-ils des parents qui ont des difficultés à poser des limites ?
· Existe-t-il des antécédents familiaux sur le plan dentaire ?
L'étude a porté sur 110 enfants âgés de 18 à 36 mois. La mère a été interrogée sur divers facteurs socio-économiques, les pratiques sur le plan de l'alimentation, la façon dont les parents définissaient des limites à l'enfant, les antécédents et pratiques familiales en matière de santé dentaire. Les enfants ont ensuite été examinés, et le nombre, l'emplacement et l'importance des caries éventuelles a été noté.
22 enfants (20%) présentaient des caries. Il n'a pas été retrouvé de différence significative entre ces enfants et les autres quant aux données démographiques et socio-économiques, sauf en ce qui concerne le niveau d'éducation de la mère : l'augmentation de ce dernier était corrélé à une baisse de l'incidence des caries. Presque tous les enfants étudiés recevaient toujours des biberons à 12 et 18 mois. La fréquence des caries était plus élevé chez les enfants qui avaient été allaités (72% contre 46%).
Cependant, la durée de l'allaitement était similaire chez les divers groupes d'enfants. Il n'y avait pas de différence significative entre les enfants pour ce qui est de l'utilisation d'une sucette, de la cuillère ou de "doudous". Il n'y avait pas non plus de différence significative dans les apports quotidiens en lait, en jus de fruit ou en glucides, ni de rapport entre ces apports et la sévérité des caries. Presque tous les enfants recevaient un biberon de lait la nuit à 12 mois, et la plupart d'entre eux en recevaient toujours à 18 mois. Aucun rapport n'a pu être mis en évidence entre la survenue de carie et ce fait, même en prenant en compte le fait que
certains enfants recevaient plus d'un biberon par nuit, qu'il pouvait dormir avec le biberon, et que le biberon pouvait contenir de l'eau. Il n'y avait pas de différence entre les mères quant à leur permissivité. Cependant, les mères dont les enfants avaient des caries étaient plus nombreuses à utiliser le biberon pour amener leur enfant à coopérer avec elles (58% contre 23%).
En fait, le seul facteur qui s'est avéré fortement corrélé à l'apparition de caries chez le bambin a été la présence de caries chez la mère. 55% des mères dont l'enfant souffrait de carie avaient elles-mêmes au moins 8 caries, contre 19% des mères dont les enfants n'avaient pas de caries. Cela avait déjà été mis en évidence dans d'autres études, et il est difficile de savoir dans quelle mesure ce fait est du à des facteurs génétiques ou environnementaux. Aucune différence significative n'a pu être retrouvée dans l'incidence des caries en fonction de la prise éventuelle de fluor, de l'âge auquel avait débuté une supplémentation en fluor, ou de l'âge auquel on avait commencé à brosser les dents de l'enfant.
Contrairement à l'opinion couramment répandue, et à ce qui a été rapporté par certaines autres études, aucune corrélation n'a pu être mise en évidence entre la prévalence des caries et l'utilisation du biberon la nuit et après l'âge de 12 mois. Cette étude a porté sur des enfants venant dans une consultation pédiatrique générale, et non dans une consultation dentaire,
ce qui peut expliquer cette différence de résultat. D'autre part, les enfants ont été vus à des âges différents, leurs apports glucidiques n'on pas pu être appréciés exactement, et les réponses des mères sur le don de biberons pouvaient être approximatives, ce qui est susceptible d'avoir faussé les résultats.
La raison pour laquelle l'incidence des caries était plus élevée chez les enfants allaités est obscure. Certains auteurs attribuent cet état de fait à la poursuite des tétées nocturnes après 2 à 3 ans. Cela ne peut cependant pas être le cas ici, la majorité des mères qui avaient allaité avaient sevré leur enfant vers 5 à 6 mois, avant même la sortie de la première dent. Il est possible que cette corrélation soit due à des biais non encore mis en évidence. Dans cette étude, le pourcentage de mères présentant au moins 8 caries était plus élevé chez les mères qui avaient allaité (72% contre 28%), ce qui, étant donné l'impact important de ce facteur, peut être une explication. 80% des mères étaient d'origine hispanique, et des facteurs
raciaux peuvent avoir une influence.
Les auteurs concluent que l'origine des caries est multifactorielle, et qu'il n'on mis en évidence aucune raison de recommander un sevrage précoce du sein ou du biberon. D'autres études sont nécessaires afin de mieux cerner les causes de ce type de caries.
The Formula Follies
Is not breastfeeding your baby the equivalent of smoking cigarettes?
BY JENNIFER GRAHAM
The Merchants of Death in Christopher Buckley's novel "Thank You for Smoking" are spokesmen for the most vilified industries in Washington: alcohol, tobacco and firearms. A lobbyist for baby formula may have to join them in a sequel. Proponents of breast-feeding, emboldened by studies that trumpet human milk's superiority to its supermarket substitutes, are abandoning platitudes like "Breast Is Best" in favor of aggressive campaigns designed to portray formula feeding as not merely inferior but dangerous.
A startling television ad in a government breast-feeding campaign likened feeding an infant formula to being thrown from a mechanical bull while heavily pregnant. Iowa Sen. Tom Harkin has proposed mandatory warning labels for formula cans. Breast-feeding advocates are pushing legislation to stop hospitals from giving free formula to new mothers. A new book calls formula feeding "deviant behavior" that should occur only as an "emergency nutrition intervention to prevent starvation and death." "There's not so much talk now about the benefits of breast-feeding," says Katy Lebbing of La Leche League International, "but the risks of not breast-feeding."
Formula, its critics say, makes children sicker, fatter and dumber. Its inability to match the antibodies of breast milk is implicated in a range of maladies, including ear infections and diabetes. It is not yet the new cigarette; few suggest that formula actually kills babies, except in rare cases when powdered formula is mixed with tainted water, for example.
But formula, once seen as the perfectly engineered health food, has become the TV dinner of infant feeding: seductively easy, nutritionally challenged and oh-so-1950s. And the campaign against it has made strange cribfellows: liberals who demand accommodation in the workplace and open-shirt nursing in the public square and conservatives who believe that young children are best cared for in their homes by mothers free to nurse on demand. Pity the bewildered new mother who wants to nurse but can't because of physical problems or her job. She is offered an astonishing array of high-tech, vitamin-rich formula but lives in a nation that exhorts choice and free will except in the baby-food aisle.
The resurgence of breast-feeding follows a buildup of research confirming benefits to mother and child that formula manufacturers have been unable to duplicate. It also closely parallels the rise of La Leche, an organization formed in 1956 by seven Chicago-area women who wanted a network of nursing mothers to support one another in what was then considered radical behavior. At that time, less than 29% of mothers were nursing their week-old infants. The percentage would eventually dip to 25% in 1971 before climbing to 70% today.
La Leche, which promotes breast-feeding through meetings and telephone support, originally appealed to "young hippies," says spokeswoman Mary Lofton. "There had been this love affair with technology, thinking if something was made in a lab, it was better. But when the back-to-nature movement came along, we were there." And, Mrs. Lofton maintains, "all of the ideas we promoted--to breast-feed right after delivery, to do it frequently . . . these were revolutionary ideas at the time, but every single one of those things is accepted pediatric practice today."
La Leche's influence is such that when the U.S. Department of Health and Human Services (HHS) launched a breast-feeding campaign in June 2004, La Leche trained the counselors who answered the government's hotlines. The goal of that continuing campaign is to get 75% of American mothers to breast-feed initially and 50% to breast-feed exclusively for at least six months. Using the catch phrase "babies are born to be breast-fed," the campaign distributes ads for television, radio and the print media. The mechanical-bull ad drew some complaints but was effective, claims Christina Pearson, an HHS spokeswoman.
While one government agency is promoting breast-feeding, however, another is handing out formula. The Women, Infants and Children (WIC) program, administered by the Department of Agriculture, gives states grants to provide free formula, food and breast-feeding support to low-income women. Nearly half of all infants in the U.S. are enrolled, and 54% of infant formula in the U.S. is distributed through WIC.
Since the late 1980s, states have negotiated contracts with formula manufacturers, who returned rebates to the states totaling $1.64 billion in 2004, the last year for which statistics are available. According to the Centers for Disease Control and Prevention, 29% of WIC recipients are breast-feeding at six months, compared with 46% of women who are eligible for WIC but don't receive the aid and 47% of ineligible women.
The result, says James Akre, the author of "The Problem With Breastfeeding" (a new book that takes issue with some of the popular aversion to breast-feeding) is that, by handing out more formula than breast pumps, the government is encouraging "deviant behavior" and "billions of dollars are going to provide poor children with food based on an alien food source"--the alien being a cow.
Mr. Akre, a resident of Geneva, Switzerland, and a retired official of the World Health Organization, believes that, as in the case of seatbelts and tobacco, a society's attitude toward breast-feeding can change in a generation. "It's not women who breast-feed, after all. It's cultures and societies as a whole," he says.
Until the late 1800s, women had little choice but to breast-feed. The only question was whether the child's mother would do it or someone else--a paid wet nurse or a slave. Every culture tried substitutes (sugared water or cow's or goat's milk early on, evaporated milk and Karo syrup more recently), but experimentation sometimes killed babies. Swiss pharmacist Henri Nestlé produced the first formula in the 1860s, saving the life of an orphaned baby and launching an $8 billion world-wide market in which Nestlé is still the leader.
The marketing of baby formula is tricky for manufacturers, which must admit on their labels that breast-milk is superior. To compensate, they rely heavily on coupons and formula samples offered through hospitals. New mothers typically leave American hospitals with a gift bag supplied by a formula manufacturer. Breast-feeding advocates want to end the practice.
Earlier this year, Massachusetts enacted the first ban on the gift bags, but it was killed by Gov. Mitt Romney, who cited the need for choice. The debate over breast-feeding simmers with political tension because it encapsulates the larger question of personal freedom versus social good. In likening formula to current public-health pariahs, breast-feeding advocates hope to send formula down a similar dark path.
The Massachusetts Breastfeeding Coalition announced plans for a nationwide "Ban the Bags" campaign at the International Lactation Consultant Association meeting in Philadelphia last week. Dr. Melissa Bartick, the coalition's chairwoman, has promised that formula marketing in hospitals won't last. She adds: "We'd never tolerate the thought of hospitals giving out coupons for Big Macs on the cardiac unit." So baby formula is not yet the new cigarette. But it's already the new Big Mac.
Ms. Graham is a writer and editor in the suburbs of Boston.
Night Weaning H’s Story.
Now, that very interesting. Especially since I am intending to get V and L (5 soon) to sleep in the same bedroom and bed. Anybody has some tips for the first nights please ?
At the moment we are still co-sleeping with little V who has just turned 2. She wakes between 2 and up to 7 times a night. Most
times she latches on without waking me, or if I am soundly asleep with my back to her, her dad asks me to turn round and helps V to find me.
L goes to bed between 9 and 10 usually, she gets very tired
towards the evening. Whereas it is impossible to get V to sleep before I go to bed and crash out with her. Even if I feed her for a long time, even if its for 1 hour 1/2, if I get up, she will wake up immediately. Which means we end up both going to bed at about midnight and she wakes up between 10 and 12 in the morning. Interestingly, she doesn't mind being on her own in the bed from 8 am onwards.
Now what annoys me is that if I get up to go for pee in the middle of the night, she will kick up a huge fuss, most of time and protest vehemently. Whatever I try, I doesn't work, she will still keep making a fuss until I come back.
I really have trouble understanding this. She is a very secure little girl, very confident. She is with me all the time, she even came to University with me until she was 15 months. She started accompanying me to university when she was 5 weeks old. So I must say I have a positive experience of close natural parenting with V whilst getting on with my activies as a student and a professional.
Lots of love to everybody and my best wishes for the New Year
Mother of L, soon 5 and V 2
Too Busy to Nurse vs Self Weaning.
First of all, an apology to S - I'm afraid my message probably wasn't all that helpful. There must be nothing worse than sending out an SOS because your baby is screaming, only to hear that someone else's baby doesn't do that... I think all we first time mothers go through so much soulsearching about whether we're doing things right. It does help to eliminate (if you can) people from your entourage who tell you that your baby is crying too much. I had someone come to help me when A was a few months old and crying quite a bit, and who told me that there was something wrong with my baby and we needed to go to the emergency room because she was crying so much.
Well, the fact was that when I held A, she didn't cry - but that woman made me extremely unsure of myself. After two days, I told her things were just not working out and I can't tell you the relief I felt not to hear someone telling me I was doing things wrong. On the subject of showers and what have you - A is almost always in whatever room I'm in, whether the shower, the toilet, whatever. I'm lucky, however, in that she no longer needs to be held 24 hours a day. Which brings me to my question and my anxiety.
As you all have probably gathered, A is much more independant then I ever expected a baby to be. She's intensly curious about everything, fascinated by new noises, new sights, new physical sensations (and yes it's confirmed - she's walking at not even 8 1/2 months) and new foods... My problem is that I am quite concerned that A is going to wean too early. Getting her to nurse during the day is an incredible challenge. I already talked to you about this in December, H, but since then it's gotten even more difficult. I've tried everything I can think of - always nursing before meals rather than after, offering her my breasts whenever possible (she'll usually nurse for about 30 seconds, almost as though she's doing me a favour - if I can get to 5 minutes I consider it a triumph!) nursing in a darkened room so there are no distractions... I carry her quite a bit in the wrap but she's always been adamant about not wanting to nurse in it. She's never had anything else to drink - no bottles of juice or water. I'm getting thankful for those nighttime nursing sessions because at least I know she's getting my milk then. Even at night she nurses very quickly - in 10 minutes she's emptied both breasts so maybe she's getting more than I think during the day? On days when she is particularly uninterested in nursing, I tend to add some pumped milk to her food to be sure she's getting some. Is this all normal? Or is this a problem? Is there something I should be doing differently? Or is this the angst of a new mother who's not sure of herself?
It's so hard to know what is normal and when I hear everyone talk about their babies nursing all the time, I think I must surely be doing something wrong...
Of course, it's a triumph that she's even nursing at all, since she hysterically refused my breast for the first five weeks of her life and maybe this is all linked... Okay, I'm going to stop burbling and send this out... Thanks for any input!
Thankyou for your other message by the way (I replied to it but it somehow didn't get sent properly and then it was lost....)
It's so exciting that A is walking!!
I'm more and more convinced that babies are all SO different, nothing is NORMAL. What is normal for A is not normal for another baby.
It seems to me you've always followed A's lead. In the beginning she got huge amounts of "peau à peau" and carrying. And you've followed her lead in putting her down (letting her get mobile, not surprisingly she's walking very early (like R) You began feeding her solids when SHE was interested. You even worked out she preferred not to be sleeping too near you. You worked out she needed to suck but she didn't want to suck on your breast. All this actually came as a surprise for you as it went against what you had expected and perhaps even dreamed of (having read all the attachment parenting-type books that we know so well).
If you had NOT followed her lead it would have been as crazy as scheduled feeding, letting her cry to sleep or all the other unnatural practices people sometimes use to make babies "conform" to their idea of what a baby should be. You allowed your daughter to be the "mode d'emploi" and she has not turned out to be the kind of 8 month-old who needs 24-hour a day carrying and non-stop nursing. Some babies are like that but some aren't.
This ties in with something you mentioned in your other message about the label "attatchment parent", which I had written to you in the message that got lost. The label is a bit misleading in that the
"attachment" bit of it refers to the needs of newborn babies to create an attachment (on-going from that within the womb).
Parents who permit this attachment, so the theory goes, give their child a sense of security which in a healthy parent-child relationship will eventually and very gradually give way to autonomy and detachment. So after a while the term "attachement parent" becomes a bit redundant. If "attachment parenting" is to be a worthwhile thing, it surely doesn't mean forcing you baby to do what she doesn't want to do. Eg. carrying her when she would rather be romping around getting hold of things, or nursing her exclusively when she obviously wants to get other food into her mouth. Or making her sleep with you when she clearly has more restful sleep if she's in her own bed.
I don't think prolonged nursing, co-sleeping, carrying etc (what some might consider to be part of the attachement parenting tool-kit) are ends in themselves, rather they are ways you can respond to your child's needs (at the same time as making life easier for yourself). If a child clearly doesn't want these things it would be absurd to force these on her.
From what you have told us you are doing everything you can to get her to nurse, it sounds like it's been like this for some time now. Her lack of interest may be, as you suggested to me once, that she didn't get used to the breast as a comforter in the early weeks.
Maybe the trauma she had at the clinic which seemed to put her off the breast in the first place did contribute to that. We will never know. But maybe it has nothing to do with that. Maybe she is just moving on in her own time to other things. Maybe she will get interested in it again. I don't think this lack of daytime nursing means she will wean soon. She may, she may not. Child-led weaning is just that. Following her lead. (Reminding her occasionally just in case she's forgotten, doesn't count as forcing, I would add! So go for it!)
Putting your milk in her food is a great idea, and you can even try and add some in on days she's nursing satisfactorily. This is a way of keeping your milk supply bountiful (pumping) as there is always the danger she could wean simply because the milk flows less ("dries up" as some people say). Since their is an advantage to keeping breastmilk in the child's diet for as long as possible, this is a justifiable way of tricking her into drinking more of it!
I knew one mother who, when her second child was born started to pump her milk to give her older child (aged about 2) in a cup even though she was already weaned. She was convinced it was helping maintain her child's health.
Anyway it sounds like those night feeds are a blessing : just think if you had night weaned her? She probably would be virtually weaned by now.
It is important that when we hear other mothers talking about what is normal for their babies we don't immediately assume something is wrong with ours (or with us). It's true whether it's about "doing her nights" or how many feeds she has a day (there's no rule). Trust you baby.
lots of love
You do not need any applogies to me. All mother's experience can enrich me and encourage me. Before I was so fragile. I thought of myself being a bad mother. Why does she cry even in my arms now since I am participating this forum, I can say to myself, “well my baby is quite demanding but it's good because I can bond with her stronger through all difficulties and problems.” In doing so, I gain more confidence.
Thank you for your story. Hearing your experience keeps me going.
Being a mother is not as easy as lots of people may think.
Initially my baby was always on my breast. Almost 24 hours a day, right up to three months. She has started to decrease that frequency recently. Now she just drinks for about 5 minutes!! I have the same feeling, that she does not drink enough but I guess she must be getting enough.
I understand your feeling quite well. I am sometimes frustrated because my baby refuses to drink my milk. At the same time, I see that she is growing well. She still loves my breast, I think. I am sometimes scared too that she might stop taking my breast.
Sorry I cannot be of any help, but I guess if your bb is developping well, then you should not worry about it so much. 20% of bbs get weaned before the age of 1 year in Japan. I hope it will not happen to me.
I had lots of breast-feeding issues when F was teeny and spoke to L.C. quite a lot (as my lactation consultant), and one of the interesting things she told me was that babies become more and more efficient nursers, so that around 8 or 9 months they can indeed drain a breast in 5 minutes. I don't think that's anything to worry about! Your rapid nursers are just growing up! F hardly nurses at all during the day, usually, but makes up for it at night.
I just wanted to say that this is quite a common age for bbs to be "just too busy to nurse right now mummy". I've heard A LOT of (non attachment) mothers saying that their bbs "self weaned" at around this age.
Everything that everyone has said so far is totally right. Its just that the majority of people are not aware of attachment parenting, natural parenting, etc. so they think that this phase is "self weaning"
Self weaning doesn't happen until after the age of 2. I mean, real self weaning, not nipple preference.
What a lot of parents think is self weaning is "just too busy...." or a nursing strike, or getting bottles instead of cups, or pacifiers.. so a lot of parents just stop offering. As they don't or haven't night fed for a long time, that huge window is also eliminated.
Up to 60% of a baby's needs are taken in night feedings...
Everything you have mentioned tells me you are hitting all angles that you could hit!
I agree with you and everyone else. Don't worry. I'm not worried for you, I have a very strong feeling you are totally following her lead, and even if it means that she's taking in a lot in 5 minutes and or getting 60% at night, you are totally ensuring her needs.
R made an important point : reminding her from time to time is not force feeding.
Thats a good idea to take her into a quiet place with fewer distractions too. I remember when A was at this same phase. The wrap helped a lot for me during that phase. It was just about the only time he was bored enough to nurse.
Pumping and making sure she gets your milk in food is a great idea. The only thing I would say is to watch out for is giving stuff (your milk or anything else) in a bottle as opposed to cups, due to risk of nipple preference.
Good for your for your perseverance and sensitivity.
Lots of love, C.
It might not help but...
My bb does not like to feed horizontally now. Before, when she was tiny, yes but not anymore. Now, each time its time to nurse, she is busy interested in other things and she refuses to feed but she needs to be fed! When my instinct tells me that she is hungry now, I put myself in a sofa, I sit down and I put her on my lap. She sits face to face, looking at me. I show her my breast and offer, “would you like some? She is interested, she touches it and puts it her in mouth, and gives it a try, I win!!!! She looks away now and then, so she does not feed continuously, but off and on ; 30 seconds, 10 seconds, 20 seconds, 1 minute, 10 seconds, then she has finished!
Also when she wakes up, she is still half sleep, so she is not yet interested in other things so I can feed her uniterupted. When she is half sleep, she accepts the breasts easily.
During the night, she feeds a lot mostly, but some nights, she does not feed a lot (twice or three times). That makes me worried, but at night I imagine she is getting enough. I sleep with her. I do not know how many times my bb drinks at night, I don't count. I sleep and she helps herself. Everyone keeps asking me how many times, how many times? Is that so important? I ask myself. Anyhow, I think she is getting enough. According to one book, as long as she moves around, she is active, then I should not worry.
Between jetlag, teething and his newfound capacities at flipping around and scooting to places, J in the last 2-3 days has decided he doesn't want to nurse more than a minute or so at a time during the day. He then goes on to marathon bouts during at night. Is this enough to keep up a milk supply? How much do babies need to nurse to keep up a good supply and do they need to be doing it at regular intervals? I must be blind, but couldn't find any answers in Motherly art of breastfeeding. Thanks for any info you may have.
As long as you are your baby's ONLY supply of nourishment it doesn't matter whether he nurses less during the day than at night. Obviously if you are giving him botlles whether it's, water, juice, formula or whatever then your supply could decrease with the decreased frequency of nursing. Try reading Dr Sears The Baby Book for more info or ask a LLL leader such as C.
Hi. So sorry you are going through this. It is fairly common though.
you'll find it under... Nursing strikes, page 142 in the latest edition; (the seventh).
In fact, it describes exactly your situations, with varying scenarios of course, and also describes exactly S's "plan of attack" plus
more techniques that may or may not be feasible for everyone (such as nursing in a swimming pool).
Basically, it signals that something is wrong. (for a nursing strike) O.K. I know, you're saying "YES, I KNOW, SO WHAT IS WRONG?!" which of course I can't tell you. Neither can your friendly family doctor.
In short, at under a year, if bb is nightfeeding which can make up 60% of a bb's intake, any short sucks during the day stimulate, so I suppose even if a bb fed only 3 times in a day but was feeding at night, the breasts would figure it out.
Breasts and our hormones are amazing. Even if there is total "weaning" for a short period (up to 40 days) it is not considered relactating, just building up a milk supply when you start up again. Milk is totally absorbed after 40 days of no demand whatsoever. Then it is considered relactating.
Lots of love, C.
Vitamin D for breastfed infants?
CHICAGO, Illinois (AP) --
The American Academy of Pediatrics says all exclusively breast-fed infants should receive vitamin D supplements to prevent rickets, a bone-weakening disease doctors fear may be becoming more common.
Breast-fed infants should receive vitamin supplements beginning at 2 months of age and until they begin taking at least 17 ounces daily of vitamin D-fortified milk, the academy says in a new policy statement. The academy recommends multivitamin supplements containing 200 international units of vitamin D, available as over-the-counter liquid drops or tablets. Supplements containing only vitamin D generally are too concentrated to be safe for routine use, it says.
The new recommendation also applies to:
• Infants who aren't breast-fed but who don't drink at least 17 ounces of fortified formula or milk daily.
• Children and adolescents who don't drink that much fortified milk, who don't get regular sunlight exposure or who don't already take multiple vitamins with at least 200 international units of vitamin D.
Breast milk contains small quantities of vitamin D and doctors used to think babies could get adequate amounts if they also spent time in sunlight, which stimulates the body to produce vitamin D.
However, growing concerns about skin cancer and recommendations that youngsters wear sunscreen and avoid excessive sun exposure may be putting some children at risk for vitamin D deficiency and rickets, said Dr. Nancy Krebs, head of the academy's nutrition committee. The new recommendation, being published Monday in April's Pediatrics, was prompted by reports of dozens of cases of rickets nationwide in recent years.
"We really hope that this is a way to optimize the health of breast-fed infants and not in any way to discourage breast-feeding," Krebs said. The federal Centers for Disease Control and Prevention highlighted concerns about rickets in a 2001 report about several Georgia youngsters hospitalised with the disease. They included breast-fed infants who did not receive vitamin D supplements.
Although reports are rising, it's not clear if the actual incidence of rickets has risen since there are no national statistics on the ailment, said CDC epidemiolog ist Kelley Scanlon.
Most recent cases of rickets have affected black children, whose skin does not absorb as much sunlight. Youngsters who spend a lot of time indoors, perhaps because of parents' long work hours or safety concerns, also are at increased risk. Symptoms include high fever and seizures in infants, and bone pain, delayed walking, small stature and bowed legs in toddlers. Youngsters can be deficient in vitamin D months before symptoms are obvious. Blood tests can diagnose the disease.
Rickets can be treated with adequate vitamin D and sometimes braces or surgery, but short stature and bone deformities may be permanent if not corrected while children are still growing.
The latest issue of Mothering magazine had a great article on this new troubling recommendation. Vitamin D isn't really a vitamin at all, it is a hormone that is synthesized
naturally when the skin is exposed to sunlight. The amount of sunlight required for a Caucasian infant is approximately two hours per week fully clothed with bare head, or about 30 minutes per week in only a diaper. Darker-skinned babies need slightly more sunlight. The time of exposure can be early morning or evening, when sunburn is less likely. The natural way for humans to acquire vitamin D is through sun exposure, not through diet.
Throughout our evolutionary history, vitamin D has NOT been a part of our traditional diet -- it is only since the very recent fortification of milk with vitamin D (to prevent rickets) that the majority of people get a substantial portion of their vitamin D through dietary means in addition to manufacturing it themselves. Vitamin D does occur naturally in some other foods (fish oils such as cod liver oil and salmon, for instance), but the body does not need to consume ANY Vitamin D in the diet in order to avoid rickets. Rickets and vitamin D deficiency are symptoms not of dietary deficiency but of lack of sufficient sun exposure. The myriad reasons why some people do not have adequate exposure to sunlight include indoor daycare and indoor work environments, unsafe neighborhoods, living at higher latitudes, living in urban areas with pollution and/or buildings that block sunlight, sunscreen use, covering much or all of the body when outside (due to custom, cold climate, fear of skin cancer). These risk factors are more likely to affect people with darker skin pigmentation, who require somewhat more sun exposure than Caucasions to synthesize adequate vitamin D.
What is wrong with proposing that breastfed infants be given vitamin D supplements? Well, here are just a few reasons:
1. Recommending that breastfed, but not formula-fed, infants need certain supplements undermines breastfeeding by suggesting that breastmilk is deficient, lacking, or inferior to formula in at least one way. There is already such a huge world-wide perception that breastfeeding and formula-feeding are roughly equivalent, and even that formula-feeding is superior. This recommendation by the AAP perpetuates the myth that technology and science are needed to complement and improve breastmilk.
2. What are the possible dangers of giving multi-vitamins to infants? Study after study shows that infants do best when given NOTHING orally except breastmilk during their first 4-6 months of life. Supplements of any kind can increase risk of allergy, change gut flora and pH, irritate the gastro-intestinal tract, and increase susceptibility to infection. In addition to vitamin D, multi-vitamin drops (the kind recommended by the AAP) contain other vitamins most certainly NOT needed by infants (and potentially harmful to them), as well as other ingredients such as sugar, preservatives, and natural and artificial flavors. It is unknown what effect supplementation of vitamins that infants don't need has on their long-term growth and development. Vitamin toxicity in the infant is possible, if mothers give more than the recommended dose or if certain infants have metabolic disorders preventing them from metabolizing and/or excreting vitamins.
3. The recommendation that all mothers give their breastfed babies vitamin drops does not address the fundamental underlying issue: that the health of some mothers and their children is at risk because they are not being exposed to adequate sunlight. Addressing the cultural, sociological, economic and political factors that make this fact a reality is much less straightforward than recommending vitamin drops for all babies. Rather, recommending vitamins gives the appearance of solving a complex public health problem while distracting us from the real issues that need to be addressed.
4. A recent study showed that Infants born to mothers with adequate vitamin D levels during pregnancy have enough stored vitamin D at birth to meet their needs for approximately eight weeks, with no supplements, even in the absence of sun exposure. I assume that the AAP recommendation to begin vitamin supplementation at two months is based on this research. However, for those babies born to mothers who did not have adequate vitamin D during pregnancy, administering supplemental vitamins beginning at the age of two months is too late -- the neonate would have been vitamin D deficient from birth (as well as in utero). It is likely that the risk factors for vitamin D deficiency apply equally to mothers and their children: dark skin pigmentation, long hours indoors because of parents' work hours, cultural or religious traditions (or simply weather) that require covering much of the skin, etc. Those infants who are most at risk for vitamin D deficiency, therefore, were probably born to mothers who were vitamin D deficient during pregnancy, and beginning supplementation at 2 months of age is not an effective treatment for those children. Those infants who are not vitamin D deficient during their first two months of life (because their mothers had sufficient vitamin D stores during pregnancy) are unlikely to need supplementation at two months or at any age. It therefore seems that an across-the-board vitamin supplementation recommendation starting at two months not only foists vitamins supplements on babies who don't need it, but fails to solve the vitamin D deficiencies of those who are truly in need: vitamin D deficient mothers, and their unborn and newborn children.
A universal recommendation for multi-vitamin supplementation in breastfed babies beginning at two months of age is ineffective at targeting those babies who are most at risk, sends a negative message about breastfeeding, foists an unnecessary cost onto breastfeeding mothers, and exposes infants to (as yet unknown) risks that may be associated with vitamin supplementation. In the absence of further research, such a recommendation is clearly unwarranted and even counterproductive.
A more effective recommendation by AAP would be to urge people to exposure themselves and their children to moderate amounts of sunlight on a regular basis. Pediatricians, family doctors, gynecologists, midwives, and other practitioners who come into contact with pregnant women and children would reinforce this recommendation and, when indicated, recommend vitamin drops only to those individuals most at risk for vitamin D deficiency.